ArticleJournal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine2020
Parasympathetic activity is reduced during slow-wave sleep, but not resting wakefulness, in patients with chronic fatigue syndrome.
Article in Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 3 of them syntheses that pooled it.
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Who cites it
13 citing papers in PubMed, 3 syntheses or guidelines pooled it, 21 citations in OpenAlex.
- Recent research in myalgic encephalomyelitis/chronic fatigue syndrome: an evidence map.Health technology assessment (Winchester, England) · 2025Pooled it
- Objective sleep measures in chronic fatigue syndrome patients: A systematic review and meta-analysis.Sleep medicine reviews · 2023Pooled it
- Associations Between Psychological and Immunological Variables in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: A Systematic Review.Frontiers in psychiatry · 2021Pooled it
- Associations between multidimensional fatigue and wearable-derived cardio-respiratory variables in post-COVID-19 patients: an observational study.Frontiers in digital health · 2026Article
- The emerging role of exosomal LncRNAs in chronic fatigue syndrome: from intercellular communication to disease biomarkers.Frontiers in molecular biosciences · 2025Review
- Predicting Sleep Quality through Biofeedback: A Machine Learning Approach Using Heart Rate Variability and Skin Temperature.Clocks & sleep · 2024Article
- A perspective on the evidence for glymphatic obstruction in spaceflight associated neuro-ocular syndrome and fatigue.NPJ microgravity · 2024Review
- Autonomic dysregulation in long-term patients suffering from Post-COVID-19 Syndrome assessed by heart rate variability.Scientific reports · 2023Article
- Major Depressive Disorder and Chronic Fatigue Syndrome Show Characteristic Heart Rate Variability Profiles Reflecting Autonomic Dysregulations: Differentiation by Linear Discriminant Analysis.Sensors (Basel, Switzerland) · 2023Article
- The Link Between Energy-Related Sensations and Metabolism: Implications for Treating Fatigue.Frontiers in psychology · 2022Review
- Four Weeks of a Neuro-Meditation Program Improves Sleep Quality and Reduces Hypertension in Nursing Staff During the COVID-19 Pandemic: A Parallel Randomized Controlled Trial.Frontiers in psychology · 2022Article
- Systematic Review of Sleep Characteristics in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.Healthcare (Basel, Switzerland) · 2021Review
- Feature of Heart Rate Variability and Metabolic Mechanism in Female College Students with Depression.BioMed research international · 2020Article
Corrections and comments
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Authors and funding
7 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
objectivesPhysiological dearousal characterized by an increase in parasympathetic nervous system activity is important for good-quality sleep. Previous research shows that nocturnal parasympathetic activity (reflected by heart rate variability [HRV]) is diminished in individuals with chronic fatigue syndrome (CFS), suggesting hypervigilant sleep. This study investigated differences in nocturnal autonomic activity across sleep stages and explored the association of parasympathetic activity with sleep quality and self-reported physical and psychological wellbeing in individuals with CFS.
methodsTwenty-four patients with medically diagnosed CFS, and 24 matched healthy control individuals participated. Electroencephalography and HRV were recorded during sleep in participants' homes using a minimally invasive ambulatory device. Questionnaires were used to measure self-reported wellbeing and sleep quality.
resultsSleep architecture in patients with CFS differed from that of control participants in slower sleep onset, more awakenings, and a larger proportion of time spent in slow-wave sleep (SWS). Linear mixed-model analyses controlling for age revealed that HRV reflecting parasympathetic activity (normalized high frequency power) was reduced in patients with CFS compared to control participants, particularly during deeper stages of sleep. Poorer self-reported wellbeing and sleep quality was associated with reduced parasympathetic signaling during deeper sleep, but not during wake before sleep, rapid eye movement sleep, or with the proportion of time spent in SWS.
conclusionsAutonomic hypervigilance during the deeper, recuperative stages of sleep is associated with poor quality sleep and self-reported wellbeing. Causal links need to be confirmed but provide potential intervention opportunities for the core symptom of unrefreshing sleep in CFS.
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Registered trials
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